Kenneth Bruce Winfrey, LMSW
Social Worker, Clinical in Albuquerque, NM. Individual provider (NPI-1).
NPI number1649500554
StatusActive
Last updated in NPPESDec 7, 2024
Details
- NPI
- 1649500554
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kenneth Bruce Winfrey
- Credential
- LMSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 28, 2009
- Certification date
- Dec 7, 2024
- Last updated
- Dec 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | M-07767 | NM | Yes |
| 104100000X | Social Worker | – | – |
Practice location
1330 San Pedro Dr NeSuite 201-B
Albuquerque, NM 87110-6744
Phone 505-410-1379
Mailing address
3150 Carlisle Blvd Ne Ste 105Albuquerque, NM 87110-1680
Phone 505-410-1379 · Fax 505-207-7421
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